The present study was an effort to study body image, sexual satisfaction, and marital adjustment in middle-aged married women. Three hundred and thirty middle-aged women were selected out of the women attending consultation centers in Gorgan, Iran, and they were asked to complete Dyadic Adjustment Scale (DAS), the Body Self-image Questionnaire, and the Persian language modified version of SQOL. Data analyses were conducted via descriptive statistics, t tests, one-way analysis of variance, Pearson’s correlation coefficients, and stepwise multiple regression. The results revealed that sexual satisfaction, body image, and marital adjustment were significantly different in terms of demographic (i.e., age, educational level, duration of marriage, living arrangement, occupation, and monthly income) and health factors (i.e., disease, exercise, frequency of sexual intercourse with spouse, and sleeping problem) excluding duration of marriage and sleeping problem for marital adjustment. It was also shown that sexual satisfaction, body image, and marital adjustment were positively and significantly correlated. Stepwise multiple regression analysis results also indicated the influencing factors on each of the variables.